Dispensing cabinets, cassettes and trays are often used to for any of storage, transportation, or distribution of medications, such as within a hospital environment. FIG. 1 is a perspective view of a simplified tray 10, such as comprising a tray structure 12, e.g. having an exemplary length 14, width 16, and height 18. The tray 12 has an interior region 20 defined therein, wherein a divider system 22 may be installed or defined therein, such as comprising one or more panels 24 and connectors 25, to create a plurality of storage compartments 26, e.g. 26a-26k, within the interior region 20 of the tray 12.
Automated dispensing cabinets (ADCs) have been used for several years within many hospital settings, for the decentralized storage and distribution of medications. Exemplary ADCs in use at this time are the Pyxis® MedStation®, available through CareFusion Corp., of San Diego, Calif., and PROmanager Rx™, available through McKesson Corp., of San Francisco, Calif.
Other carts and storage cabinets are also available that provide for storage within patient care areas, such as to cut down on trips to an ADC. Such carts and cabinets are required to be replenished by a hospital pharmacy, are inherently limited in their storage capacity, and are often not adequately mobile to move from room to room.
Hospitals commonly purchase medications in bar-coded single dose packages that are stored in ADCs. Computers associated with hospital pharmacies allow review of orders before a drug is administered. ADCs allow authorized access to medication within a patient care area, such as by a nurse or clinician, wherein the ADC dispenses medications to the nurse or caregiver, for subsequent transport and administration to the patient.
Patient-specific trays or cassettes are commonly filled with unit-dose medications, such as at a hospital pharmacy or from an ADC, wherein the cassettes are typically delivered to a nursing unit, where they may be stored within medication cabinets or carts. At the time of administration, the attending doctor, nurse or clinician records the administration of medications in an electronic medical administration record (eMAR).
A significant portion of a nurse's time is associated with the administration of medications, and each patient commonly receives several medications on any given round. While it is often preferred that a nurse transports medications for administration to a single patient at a time, such as due to concerns for safety, this requires a great deal of time and travel for a nurse. Based upon the proximity of the ADC, it is sometimes desired that medications for more than one patient be stored on a cart. While some institutions forbid this, as it increases the risk of administering the wrong medication, other institutions allow the simultaneous storage and transport of medications for multiple patients.
FIG. 2 is a flow chart of an exemplary workflow process cycle 50 for dispensing medications with an automated dispensing cabinet and a conventional dispensing tray or cassette. For example, a pharmacy typically fills or replenishes 52 the automated dispensing cabinet. A nurse then gets 54 the medications from the automated dispensing cabinet and fills a tray or cassette, while checking 56 the medications against order information. The nurse may proceed 58 as needed to get any missing medications, refrigerated medications, and/or solution bags, etc., and then transport 60 the medications to a patient. The nurse then typically bar codes 62 both the patient, e.g. having an identification bracelet, and the medications, such as to provide inventory control and to prevent human errors. The nurse then prepares 64 the medications as necessary, such as but not limited to cutting pills, and/or dissolving medications in water. The nurse then administers 66 the medications, verifies 68 ingestion of the medications, and makes 70 an electronic medication record, such as associated with the patient chart. The nurse then typically discards 72 any wrappers if needed, and disposes 74 of any waste medications, such as with secondary verification.
The simplified tray 10 seen in FIG. 1, such as when placed on a cart for transportation to a patient, does not inherently provide security for the contents that may be carried within, wherein contents may readily fall out, be stolen, and/or tampered with. Such an inherently low level of security at any point during a workflow process, such as seen in FIG. 2, can pose undue risk to the patient or to others. As well, caregivers are frequently interrupted during their process of accessing, transporting, and/or administering medications, and often have to find or locate a second nurse to verify administration, such as for a high-risk drug, thus increasing the risk further.
It would therefore be advantageous to provide a medical drawer structure that provides enhanced security during a workflow process associated with the transport and administration of medications.
Some prior cabinets and carts provide keyless entry for standard drawers, such as with a keypad or electronic key lock assembly. However, such structures typically require the use of simple medical trays, e.g. 10, to be placed within such drawers. Discrete medical trays that are placed within such a lockable drawer are not directly tracked as to their location and access, wherein the drawer is not directly dockable to the drawer or cabinet system. Such a tray may be absent from the drawer when the drawer is in the closed and locked position.
It would therefore be advantageous to provide a medical drawer structure that provides direct docking and security for a dispensing tray. The development of such a structure would constitute a major technological advance.
While some mobile carts include mechanical locks to provide security for medication trays or cassettes, such locks require a mechanical key for operation. However, keys are easily lost, and do not provide any traceability to individual users. While some prior carts have included keyless entry for one or more standard drawers, such drawers are not configured to be removable, and when used for dispensing medications, require a separate tray or cassette to be stored within and removed therefrom, e.g. such as a tray 10 as seen in FIG. 1.
It would therefore be advantageous to provide a removable drawer structure that provides lockable access to medications, without the use of mechanical keys. The development of such a drawer structure would constitute an additional technological advance. As well, it would be advantageous to provide a removable drawer structure that provides traceability to individual users. The development of such a drawer structure would constitute a further technological advance.
While stationary cabinets can provide security for medications, such as for storage at a nurses station, medical dispensing trays and cassettes are commonly required to be transported throughout a medical facility, and are commonly required to be scanned at a location of administration to a patient.
It would therefore be advantageous to provide a secure dispensing drawer structure that is readily integrated into a mobile cart, which can be readily moved throughout a work area. The development of such a drawer structure would constitute a major technological advance. Furthermore, it would be advantageous to provide such a secure mobile drawer structure that is readily integrated with other equipment, such as to provide any of barcode scanning, alarms, and/or patient charting. The development of such a system would constitute a further technological advance.